Functional Assessment Of Patients With Bone Sarcomas Submitted To Surgical Treatment Using Total Or Partial Prosthesis In Replacement Of The Distal Femoral End [avaliação Funcional Dos Pacientes Portadores De Sarcomas ósseos Submetidos à Tratamento Cirúrgico Utilizando A Endoprótese Total Ou Parcial, Na Substituição Da Extremidade Distal Do Fêmur]

Objectives: Osteosarcoma and Ewing's sarcoma are the most common malignant primary bone tumors in individuals under the age of 15 years. The purpose of the study is to retrospectively compare functional outcomes of patients submitted to resection of the distal femoral end and to reconstruction with total or partial non-conventional prosthesis of the knee. Methods: We assessed 26 patients with bone sarcomas in the distal femoral end treated at the Boldrini's Children Center between 1990 and 2003. Twenty-four presented with Osteosarcoma and two had Ewing's sarcoma. The assessment system employed was the one proposed by Enneking (1987) as recognized by the Musculoskeletal Tumor Society. For the statistical analysis between the criteria and final scores, we have used the Wilcoxon's test, with an alpha error of 5%. Results: Ages ranged from 5 to 17 years, (mean: 11 years and 9 months); with prevalence being higher in females (61.5%). The only statistically significant difference found in this study was concerned to stability (p=0.0037). No statistical significance was found on any other criteria such as movement (p=0.7546), pain (p=0.4848), deformity (p=0.8695), strength (p=1.0000), functional activities (p=0.9127) and final functional outcome (p=0.5866). Conclusions: The overall functional end score did not show statistically significant differences (p=0.6027). The type of prosthesis for femoral reconstruction did not affect patients' functional outcomes.161131

Vascular Pattern In Enchondroma And Chondrosarcoma: Clinical And Immunohistologic Study

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Introduction: Although cartilaginous tumors have low microvascular density, vessels are important for the provision of nutrition so that the tumor can grow and generate metastasis. The aim of this study was to assess the value of the vascular pattern classification as a prognostic tool in chondrosarcomas (CSs) and its relation with vascular endothelial growth factor (VEGF) expression.Materials and Methods: This was a retrospective study of 21 enchondromas and 57 conventional CSs. Clinical data and outcome were retrieved from medical files. CSs histologic grades (on a scale of 1 to 3) were determined according to the World Health Organization classification. The vascular pattern (on a scale of A to C) was assessed through CD34, according to Kalinski. CD105 and VEGF were also evaluated.Results: Poor outcome was significantly associated with vascular pattern groups B and C. Higher vascular pattern were 6.5 times more frequent in moderate-grade and high-grade CSs than in grade 1 CS. On multivariate analysis, a clear correlation was found between VEGF overexpression and B/C vascular patterns. Only 18 (benign and malignant) tumors stained for CD105.Discussion: The results point to the use of the vascular pattern classification as a prognostic tool in CSs and to differentiate low-grade from moderate-grade/high-grade CSs. Vascular pattern might be also used to complement histologic grade, VEGF immunostaining, and microvascular density, for indicating a patient's prognosis. Low-grade CSs develop under low neoangiogenesis, which conforms to the slow growth rate of these tumors.228600605FAPESP; São Paulo Research FoundationFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Grifone, T.J., Haupt, H.M., Podolski, V., Immunohistochemical expression of estrogen receptors in chondrosarcomas and enchondromas (2008) Int J Surg Pathol, 16, pp. 31-37Reliability of histopathologic and radiologic grading of cartilaginous neoplasms in long bones (2007) J Bone Joint Surg Am, 89, pp. 2113-2123Kalinski, T., Roessner, A., Angiogenesis in cartilage tumors (2010) Pathologe, 31, pp. 177-182Folkman, J., Tumor angiogenesis (1985) Adv Cancer Res, 43, pp. 175-203Dvorak, H.F., Brown, L.F., Detmar, M., Vascular permeability factor/vascular endothelial growth factor, microvascular hipermeability and angiogenesis (1995) Am J Pathol, 146, pp. 1029-1039McGough, R., Aswad, B., Terek, R.M., Pathologic neovascularization in cartilage tumors (2002) Clin Orthop Relat Res, 397, pp. 76-82Terek, R.M., Angiogenesis in chondrosarcoma (2002) Curr Opin Orthop, 13, pp. 449-453Mayrogenesis, A.F., Gambarotti, M., Angelini, A., Chondrosarcoma revisited (2012) Orthopedics, 35, pp. 379-390Amstalden, E.M.I., Tumores do sistema osteoarticular (2004) Patologia Diagnostica de Tumores, pp. 345-352. , Billis A, Vassalo J, eds., 2nd ed. Campinas, Brazil: Impressão Digital do Brasil Grá fica e EditoraMurata, M., Yudoh, K., Masuko, K., The potential role of vascular endothelial growth factor (vegf) in cartilage: How the angiogenic factor could be involved in the pathogenesis of osteoarthritis? (2008) Osteoarthritis Cartilage, 16, pp. 279-286Ayala, G., Lui, C., Nicosia, R., Microvasculature and vegf expression in cartilaginous tumors (2000) Hum Pathol, 31, pp. 341-346Kalinski, T., Krueger, S., Sel, S., Differential expression of vegfa and angiopoetins in cartilage tumors and regulation by interleukin-1b (2006) Cancer, 106, pp. 2028-2038Falcone, G., Rossi, E.D., Maccauro, G., Diagnostic relevance of the immunohistochemical detection of growth factors in benign and malignant cartilaginous tumors (2006) Appl Immunohistochem Mol Morphol, 14, pp. 334-340Sutton, K.M., Wright, M., Fondren, G., Cyclooxygenase-2 expression in chondrosarcoma (2004) Oncology, 66, pp. 275-280Endo, M., Matsumura, T., Yamaguchi, T., Cycloxygenase-2 overexpression associated with a poor prognosis in chondrosarcomas (2006) Hum Pathol, 37, pp. 471-476Schrage, Y.M., Machado, I., Meijer, D., COX-2 expression in chondrosarcoma: A role for celecoxib treatment? (2010) Eur J Cancer, 46, pp. 616-624Nakagawa, S.A., Lopes, A., Lopes De Carvalho, A., Nitric oxide synthase, cycloxigenase-2, nitrotyrosine, and angiogenesis in chondrosarcoma and their relation to prognosis (2010) Bone Joint Surg Am, 92, pp. 1738-1746Kalinski, T., Sel, S., Kouznetsova, I., Heterogeneity of angiogenesis and blood vessel maturation in cartilage tumors (2009) Pathol Res Pract, 205, pp. 339-345Wang, X.L., De Beuckeleer, L.H., De Schepper, A.M., Low-grade chondrosarcoma vs enchondroma: Challenges in diagnosis and management (2001) Eur Radiol, 11, pp. 1054-1057Weiner, S.D., Enchondroma and chondrosarcoma of bone: Clinical, radiologic, and histologic differentiation (2004) Instr Course Lect, 53, pp. 645-649Santacreu, E.M.F., Cruz, E.J.O., López, J.M.G., Enchondorma verus low-grade chondrosarcoma in apendicular skeleton: Clinical anda radiological criteria (2012) J Oncol, 2012, p. 437958Dorfman, H.D., Czerniak, B., Bone cancers (1995) Cancer, 75, pp. 203-210Krause, D.S., Fackler, M.J., Civin, C.I., CD34: Structure, biology, and clinical utility (1996) Blood, 87, pp. 1-13Lindenmayer, A.E., Miettinen, M., Immunophenotypic features of uterine stromal cells. Cd34 expression in endocervical stroma (1995) Virchows Arch, 426, pp. 457-460Fina, L., Molgaard, H.V., Robertson, D., Expression of the cd34 gene in vascular endothelial cells (1990) Blood, 15, pp. 2417-2426Brekken, R.A., Li, C., Kumar, S., Strategies for vascular targeting in tumors (2002) Int J Cancer, 100, pp. 123-130Sanchez-Elsner, T., Botella, L.M., Velasco, B., Endoglin expression is regulated by transcriptional cooperation between the hypoxia and transformin growth factor-beta pathways (2002) J Biol Chem, 277, pp. 43799-43808Kumar, S., Ghellal, A., Li, C., Breast carcinoma: Vascular density determined using cd105 antibody correlates with tumor prognosis (1999) Cancer Res, 59, pp. 856-861Minhajat, R., Mori, D., Yamasaki, F., Endoglin (cd105) expression in angiogenesis of colon cancer: Analysis using tissue microarrays and comparison with other endothelial markers (2006) Virchows Arch, 44, pp. 127-134Sharma, S., Sharma, M.C., Sarkar, C., Morphology of angiogenesis in human cancer: A conceptual overview, histoprognostic perspective and significance of neoangiogenesis (2005) Histopathology, 46, pp. 481-489Hillen, F., Griffioen, A.W., Tumor vascularization: Sprouting angiogenesis and beyond (2007) Cancer Metastasis Rev, 26, pp. 489-502Cintra, F.F., Cassone, A.E., Gonçalves, J.C.B., Prognostic significance of cyclooxygenase-2 (cox-2) expression in cartilaginous tumors (2010) Histopathology, 57, p. 20Giuffrida, A.Y., Burgueno, J.E., Koniaris, L.G., Chondrosarcoma in the united states (1973 to 2003): An analysis of 2890 cases from the seer database (2009) J Bone Joint Surg Am, 91, pp. 1063-1072Chow, W.A., Update on chondrosarcomas (2007) Curr Opin Oncol, 19, pp. 371-376Cintra, F.F., (2012) Análise de Fatores Angiogênicos e da Expressão da COX- 2 em Tumores de Linhagem Cartilaginosa-Correlação Clínica e Histológica [Tese-Doutorado], , Campinas SP: Universidade Estadual e CampinasStepanova, E.V., Kharatishvili, T.K., Lichnitser, M.R., Prognostic significance of p53, her-2/neu, ki-67 and vegf expression in chondrosarcomas (2002) Arkh Patol, 64, pp. 9-12Fonsatti, E., Sigalotti, L., Arslan, P., Emerging role of endoglin (cd105) as a marker of angiogenesis with clinical potential in human malignancies (2003) Curr Cancer Drug Targets, 3, pp. 427-432Postiglione, L., Di Domenico, G., Caraglia, M., Differential expression and cytoplasm/membrane distribution of endoglin (cd105) in human tumour cell lines: Implications in the modulation of cell proliferation (2005) Int J Oncol, 26, pp. 1193-1201Luque, A., Slevin, M., Turu, M.M., CD105 positive neovessels are prevalent in early stage carotid lesions, and correlate with the grade in more advanced carotid and coronary plaques (2009) J Angiogenes Res, 1, pp. 6-16Manor, E., Kachko, L., Puterman, M.B., Cystic lesions of the jaws - A clinicopathological study of 322 cases and review of the literature (2006) J Med Sci, 9, pp. 20-26Yamamoto, F.P., (2010) Estudo da Presença de Osteonecrose Na Mandíbula Após Exodontia de Molares em Ratos Tratados Com Alendronato de Sódio [Tese-Doutorado], , São Paulo: Universidade de São Paul

Punção aspirativa por agulha fina como método de coleta de material para a histopatologia no osteossarcoma canino

Para a obtenção do diagnóstico definitivo do osteossarcoma realizam-se exames citopatológico e histopatológico. O material para exame citopatológico é coletado através de punção aspirativa por agulha fina (PAAF), já para a realização do exame histopatológico é necessário uma amostra de tamanho maior, geralmente conseguida através de biópsia incisional. Este trabalho tem como objetivo desenvolver uma técnica de coleta de material em cães com suspeita de osteossarcoma através de PAAF para a realização de exame histopatológico. Foram coletadas duas amostras de 12 cães suspeitos de osteossarcoma por PAAF. O material obtido pela primeira coleta foi utilizado para confirmar o diagnóstico através do exame citopatológico, enquanto que o material oriundo da segunda coleta foi fixado em formol a 10% para a análise histopatológica. Quatro das 12 amostras (33,3%) avaliadas histopatologicamente pela metodologia proposta obtiveram também o diagnóstico de osteossarcoma. Esses resultados apontam para uma possível adequação da técnica de coleta de material por PAAF para exame histopatológico.<br>Cytopathologic and histopathologic tests are important to obtain a definitive diagnosis of osteosarcoma. The sample for cytopathological exam is collected through fine-needle aspiration cytology (FNA). On the other hand, histopathological exams need a larger sample that is usually obtained by incisional biopsy. The objective of this article is to develop a FNA technique to biopsy and evaluate histopatologically samples of dogs with suspected osteosarcoma. Two FNS samples were collected from 12 such dogs. Samples obtained in the first procedure were examined cytologically. The material sampled at the second biopsy was fixed in 10% formalin and submitted to histopathological analysis. Four out of the 12 samples (33.3%) examined by the herein proposed method were diagnosed as osteosarcoma. These results indicate a possible adaptation of FNA for histopathological examination